Story 1: The American People and Electoral College Not Congress Will Decide The Winner of The 2020 Presidential Election — Trump Should Win In A Landslide Victory — Do Not Be Surprised WhenTrump Wins A Majority of The Votes With 70 Million Plus Popular Votes and 330 Plus Electoral College Votes — Elections and Impeachments Have Consequences — Over And Over — Long and Winding Road — All By Myself — I DID IT MY WAY — Videos —

U.S. Senate: Impeachment Trial (Day 3)

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Impeachment Doesn’t Require a Crime

President Donald Trump talks with reporters next to Senate Majority Leader Mitch McConnell and Sen. Roy Blunt as he arrives for a closed Senate Republican policy lunch on Capitol Hill, March 26, 2019. (Brendan McDermid/Reuters)

Senate Republicans, by and large, have reached an unspoken consensus about President Trump and Ukraine. He should not have put a temporary freeze on congressionally authorized aid to Ukraine, should not have dabbled with using the aid to get Ukraine to investigate Joe Biden or a nutty theory about Ukrainian hacking during the 2016 election, and should not have kept defending his “perfect call” as such. At the same time, his conduct does not merit his removal from office — especially since voters will get to pass judgment on that conduct in a few months.

It’s a reasonable position, and it’s the case that Republicans ought to make in public. They are inhibited from doing so by the president’s obstinacy. Instead of sticking to the most defensible case for a Senate acquittal of Trump, Republicans from the president on down are making arguments that range from the implausible to the embarrassing.

Hence the claim now being advanced half-heartedly by Republicans that presidents cannot be impeached for any abuse of power unless that abuse took the form of a criminal violation of a statute. The consensus of those who have studied this question is to the contrary. Jonathan Turley, the Republicans’ star witness in the House hearings about the constitutional issues raised by impeachment, has repudiated this view. Attorney General William Barr has in the past denied it. The Founding-era debates about impeachment are clear that Congress was to be able to remove a president from office if he had exercised his legal powers in an abusive way. One example that came up during those debates: What if the president tacitly encouraged a crime and then pardoned the perpetrator? The pardon power is arguably unreviewable, and certainly very nearly so. It was left to the judgment of a majority of the House and a supermajority of the Senate, as always under the supervision of the voters, whether a president’s conduct had rendered his continuation in office intolerable.

Attempts to impeach presidents have thus frequently combined charges of crimes with charges of non-criminal abuses. A categorical denial of the latter class of charge would do violence to the Constitution and one of its checks on presidential misconduct. Republicans would be better off arguing that in this case the president’s behavior, while objectionable, should be left, as scheduled, to the judgment of the voters directly — an argument that already has the support of most voters in polls and accords with Senate Republicans’ actual beliefs. There is no need for constitutional contortions.

A very common refrain among loyal defenders of President Donald Trump amid the current impeachment proceedings is that, because there was no crime committed, he cannot be removed from office. It is a rather shockingly simple defense that parades one’s middle school level of understanding of the Consitution or is a willfully misleading take designed to misinform the misinformable.

Enter conservative thought leader National Review into this strange legal defense phenomenon, to publish a remarkably banal take in the form of a scathing Op-Ed that rather embarrasses Trump’s loyal defenders. It’s banal not because of National Review’s editorial wisdom, but because we sadly find ourselves in a political moment when even the banalest takes need to be said.

Editors behind the column say of this “no-crime” defense: “Instead of sticking to the most defensible case for a Senate acquittal of Trump, Republicans from the president on down are making arguments that range from the implausible to the embarrassing.”

The op-ed features a remarkably effective, if not on-the-nose, headline “Impeachment Doesn’t Require a Crime” which features the following nut graf:

Hence the claim now being advanced half-heartedly by Republicans that presidents cannot be impeached for any abuse of power unless that abuse took the form of a criminal violation of a statute. The consensus of those who have studied this question is to the contrary. Jonathan Turley, the Republicans’ star witness in the House hearings about the constitutional issues raised by impeachment, has repudiated this view. Attorney General William Barr has in the past denied it. The Founding-era debates about impeachment are clear that Congress was to be able to remove a president from office if he had exercised his legal powers in an abusive way. One example that came up during those debates: What if the president tacitly encouraged a crime and then pardoned the perpetrator? The pardon power is arguably unreviewable, and certainly very nearly so. It was left to the judgment of a majority of the House and a supermajority of the Senate, as always under the supervision of the voters, whether a president’s conduct had rendered his continuation in office intolerable.

The National Review editors don’t so much chide Republicans for what seems a foolhardy errand of alleging the “no-crime” defense, but rather it arrives at a rather thoughtful suggestion that Republicans would be better served by arguing that President Trump’s behavior, while objectionable, should be left to voters.

Attempts to impeach presidents have thus frequently combined charges of crimes with charges of non-criminal abuses. A categorical denial of the latter class of charge would do violence to the Constitution and one of its checks on presidential misconduct. Republicans would be better off arguing that in this case the president’s behavior, while objectionable, should be left, as scheduled, to the judgment of the voters directly — an argument that already has the support of most voters in polls and accords with Senate Republicans’ actual beliefs. There is no need for constitutional contortions.

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Fever – Peggy Lee

Peggy Lee: Fever!

Fever

Never know how much I love you
Never know how much I care
When you put your arms around me
I get a fever that’s so hard to bear
You give me fever (you give me fever) when you kiss me
Fever when you hold me tight (you give me fever)
Fever in the mornin’
Fever all through the night

Sun lights up the day time
Moon lights up the night
I light up when you call my name
‘Cause I know you’re gonna treat me right
You give me fever (You give me fever) when you kiss me
Fever when you hold me tight (You give me fever)
Fever in the mornin’
Fever all through the night (Wow!)

Everybody’s got the fever
That is somethin’ you all know
Fever isn’t such a new thing
Fever started long time ago

Romeo loved Juliet
Juliet she felt the same
When he put his arms around her
He said, “Julie baby you’re my flame”
Thou givest fever when we kisseth
Fever with thy flaming youth
Fever I’m on fire
Fever yea I burn forsooth

Captain Smith and Pocahontas
Had a very mad affair
When her daddy tried to kill him
She said “Daddy oh don’t you dare”
“He gives me fever with his kisses”
“Fever when he holds me tight”
“Fever, I’m his missus”
“Daddy won’t you treat him right?”

Now you’ve listened to my story
Here’s the point that I have made
Chicks were born to give you fever
Be it Fahrenheit or centigrade
We give you fever when we kiss you
Fever if you live and learn
Fever till you sizzle
What a lovely way to burn
What a lovely way to burn
What a lovely way to burn
What a lovely way to burn

Scientists now believe that the deadly virus spreading around the globe from China was passed to humans from snakes sold at the open-air market in Wuhan.

Researchers at Peking University believe that 2019-nCoV, the SARS-like coronavirus that’s infected more than 500 people worldwide and killed 17, is made up of a combination of one that affects bats and another, totally unknown coronavirus.

They think genetic material from the two recombined, picked up a protein that lets viruses bind to certain host cells – including those of humans.

When they analysed the genes of strains affecting various host animals, the team found that snakes were susceptible to the most similar version of the coronavirus, and likely provided a ‘reservoir’ for the viral strain to grow stronger and replicate.

Sold alongside a menagerie the included live koalas, rats and wolf pups at the Huanan Seafood Market in central Wuhan – now thought to be the outbreak’s epicentre – snakes likely then served as the jumping-off point for the virus to begin infecting humans.

Snakes sold at the Huanan Seafood Market (shown right, on the market’s price list) in Wuhan, China, were the likely source of the coronavirus outbreak now spreading around the globe

Photo of a store at Wuhan Huanan Seafood Market selling wild animals including live wolf pups, koalas and civets

‘Results derived from our evolutionary analysis suggest for the first time that snake is the most probable wildlife animal reservoir for the 2019-nCoV,’ the authors wrote in the Journal of Medical Virology.

‘New information obtained from our evolutionary analysis is highly significant for effective control of the outbreak caused by the 2019-nCoV-induced pneumonia.’

Most types of virus have many different strains, but no all of them occur in all places, and not every strain can infect every species.

For their new study, the Peking University team sequenced the genomes of 272 strains of coronavirus.

The new strain that’s emerged from China is only the seventh version of a coronavirus known to infect humans.

Four are common causes of colds and generally don’t lead to severe illnesses.

Deadlier coronaviruses include severe acute respiratory syndrome (SARS), first seen in China in 2003 and Middle Eastern Respiratory Syndrome (MERS) which emerged in Saudi Arabia in 2013.

And now, the new mysterious Chinese coronavirus known – for now – as 2019-nCoV, which cropped up at the Huanan Seafood Market in December.

Live animal and game markets are not uncommon sources of new viral illnesses that afflict humans (although this in itself is an uncommon occurrence).

Where animals mix and mingle, so do the viruses the carry. And when viruses mix and mingle, they can exchange genetic material, mutating and become novel strains.

This seems to be the case with the current coronavirus outbreak.

According to the new study, the new coronavirus’s genetic material – RNA, unlike some viruses that are composed of DNA – looks to be a cross-breed of a strain known to infect bats and one for which they couldn’t pinpoint a known match.

What species a virus is able to infect depends on what proteins it has on the surfaces of its cells, and whether they can bind to the receptors on the surfaces of other animals’ cells.

So somewhere along its evolutionary path, 2019-nCoV picked up a protein or protein keys that turned the lock to give it access to snakes.

From there proliferated and mutated in such a way that may have given it access to humans shopping the Huanan Seafood Market.

The market has since been closed and has been labelled ‘ground zero’ by local authorities.

The highly-contagious virus has killed 17 people and infected hundreds in China, South Korea, Japan, Thailand, Hong Kong and the US.

A list of prices for one of the businesses operating at the market showed a menagerie of animals available for sale including live foxes, crocodiles, wolf puppies, giant salamanders, snakes, rats, peacocks, porcupines, koalas and game meats.

The study authors believe their work likely narrows down the source of the virus from the list of 112 live animals and animal products that were sold at the market that’s likely the outbreak’s epicenter.

The highly-contagious virus has killed 17 people and infected hundreds in China, South Korea , Japan , Thailand , Hong Kong and the US

‘Freshly slaughtered, frozen and delivered to your door,’ said the price list for the vendor called Wild Game Animal Husbandry for the Masses.

Gao Fu, director of the Chinese centre for disease control and prevention, said in Beijing on Wednesday that authorities believe the virus likely came from ‘wild animals at the seafood market’ though the exact source remains undetermined.

10 THINGS TO KNOW ABOUT CHINA’S CORONAVIRUS

1. At least 17 people have been killed, all in the Chinese province of Hubei

2. At least 500 people in China’s 18 provinces, autonomous regions, special administrative regions and municipalities have been infected

3. The vast majority of patients are related to Wuhan, the provincial capital of Hubei with a population of around 11 million

4. Thailand, South Korea, Japan, Taiwan and the United States have all reported confirmed cases

5. The virus can be passed between humans

6. It has certain ability to spread within a neighbourhood

7. The virus has mainly been passed through the human respiratory system

8. The source of the virus has been identified as the illegally sold wildlife meat

9. The virus can evolve

10. It is more difficult for children to contract the virus, the reason remains unknown

Source: China’s National Health Commission, People’s Daily

China bans the trafficking of a number of wild species or requires special licences, but regulations are loose for some species if they are commercially farmed.

The Beijing News published a photo on Tuesday showing the same vendor’s now-shuttered store front, as authorities in white hazmat suits milled about.

The paper also quoted other merchants as saying trade in wildlife took place up until the market was shuttered for disinfection shortly after the outbreak.

A number of the early sufferers of the coronavirus were employees of the market.

The new screening efforts will only be in place at Sydney Airport where three direct flights from Wuhan land per week on Mondays, Thursdays and Saturdays.

When China Eastern Airlines flight MU749 lands on Thursday, passengers will be met by biosecurity staff from New South Wales Health and Border Force officials.

Huanan seafood market has been closed while Authorities carry out checks and cleaning

Passengers are expected to be screened for high temperatures with thermal imaging – but the method is not 100 per cent successful because people can harbour the coronavirus with no symptoms for days.

Anyone who does have a high temperature or is feeling unwell will be interviewed by officials.

It comes as US health authorities on Tuesday announced the first case of a person on American soil being diagnosed with the virus as millions of travelers prepare to take flights for Lunar New Year on Saturday.

Plane passengers in China are being screened after an outbreak of the deadly coronavirus

Plane passengers in China screened for coronavirus symptoms

Bats are thought to have spawned SARS, which in 2002-03 killed hundreds of people in Asia, mostly China.

SARS was also found in civets in wildlife markets in China, with many scientists believing the bat virus infected the cat-like creatures and then humans who ate them.

Following SARS, China cracked down on consumption of civets and some other species, but conservationists say the trade continues.

China has so far won praise for its openness and handling of the current outbreak in stark contrast to SARS, when it was accused of stifling information and failing to cooperate with the rest of the world.

What do we know about the new kind of coronavirus?

WHAT IS THE DISEASE?

Scientists have identified it as a new kind of coronavirus. There are many known types of coronaviruses. Some cause the common cold. Others found in bats, camels and other animals have evolved into more severe illnesses such as SARS (severe acute respiratory syndrome) or MERS (Middle East respiratory syndrome).

WHY IS IT CALLED A CORONAVIRUS?

Corona comes from Latin and refers to crowns or halos. Under a microscope, these viruses resemble crowns or halos.

WHEN WAS THE NEW VIRUS FOUND?

The outbreak started late last month in the city of Wuhan in central China, apparently at Huanan Seafood Market.

HOW MANY PEOPLE HAVE IT AND HOW WIDESPREAD IS IT?

About 300 cases have been identified. There are about 260 cases in Wuhan, according to Chinese officials. Cases in other Chinese cities, including Beijing and Shanghai, total around 30. They were reported with the onset of an annual travel rush for the Lunar New Year holiday. Many Chinese travel abroad for the holiday and a few cases have been confirmed outside the mainland – in South Korea, Japan, Thailand and Taiwan. That travel rush is expected to spread the disease more widely.

WHAT ARE THE SYMPTOMS?

Common symptoms include a runny nose, headache, cough and fever. Shortness of breath, chills and body aches are associated with more dangerous kinds of coronavirus, according to the U.S. Centers for Disease Control and Prevention.

HOW ARE CORONAVIRUSES SPREAD?

Many coronaviruses can spread through coughing or sneezing, or by touching an infected person. Initially, authorities in China said there was no evidence of human-to-human transmission in the present outbreak. But an expert panel has concluded there have been at least a few cases of people catching it from others, raising the possibility it could spread more widely.

COULD IT BE AS BAD AS SARS?

So far, the virus appears less dangerous and infectious than SARS, which also started in China and killed about 800 people. As of Tuesday, six deaths had been reported, all in Wuhan. Viruses can mutate into more dangerous and contagious forms, and it’s too early to say what will happen.

A visual guide to the Wuhan coronavirus

An outbreak of new coronavirus in China has sickened more than 600 people and killed at least 17, while spreading to countries around the world.

Its emergence has fueled fears of a deadly epidemic as hundreds of millions of people travel in China, or around the Asian region, for the Lunar New Year holiday.

What is the virus?

Coronavirus is a large family of viruses, which include severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

Common symptoms include a runny nose, cough, sore throat, and possibly a headache. Those who have a weakened immune system, particularly the young and the elderly, are at risk of the virus turning into a more serious respiratory tract illness.

Authorities said the Wuhan coronavirus was passed from animals to humans; can be spread from person to person; and appears to cause pneumonia in people who have weakened immune sytems.

In one instance, 14 doctors and nurses operating on a patient — who was not known to be carrying the virus — were all infected with it, suggesting it can be spread relatively easily.

Where is this happening?

Where it started: Ground zero

The outbreak emerged last month in the largest city in central China, Wuhan, a city of 11 million people in Hubei province.

Officials linked it to Huanan Seafood Wholesale Market, saying wild animals sold there are the likely source of the virus. The market has been closed since January 1 for disinfection and officials are scrambling to discover its animal source.

Snakes — the Chinese krait and the Chinese cobra — may be responsible for transmitting coronavirus to humans.

Scientists in China say that the virus might have jumped from bats to snakes, which were sold in the local seafood market in Wuhan, and then to humans.

However, how the virus could adapt to both the cold-blooded and warm-blooded hosts remains a mystery, and further tests are necessary to determine the source animal.

At least nine people have died in the province, the majority of them elderly and suffering from pre-existing conditions.

As deaths mount in the city, officials imposed a number of new measures including the postponement of New Year celebrations in Wuhan, a ban on tour agencies from bringing groups of people out of the city and thermal monitors and screening in public spaces.

Regional spread

From the first reported case in December, in Hubei province, the virus has spread toalmost all of China’s administrative regionsthis week.

The country has adopted prevention and control measures that are typically used for major outbreaks such as plague and cholera. This means health officials will get sweeping powers to lock down affected areas and quarantine patients.

Wuhan “temporarily” closed its airport and railway stations on Thursday for departing passengers, and all public transport services are suspended until further notice.

The city’s coronavirus task force also announced the closure of highways out of the city.

Meanwhile, the city made it mandatory for everyone to wear face masks in public places after confirmed coronavirus cases passed the 500 mark.

A global threat: Confirmed cases around the world

The virus has spread well beyond mainland China, so far to Thailand, Japan, South Korea, Taiwan and the United States.

Airports around the world have increased health screenings and implemented new quarantine procedures as officials race to slow the spread of the virus.

International flights from Wuhan

Wuhan is a major transportation hub.

Not only is it a center for China’s high-speed rail network, it has flights going to more than 60 international destinations from Tianhe International Airport.

In Wuhan itself, infrared thermometers have been installed at the airport, train stations, coach terminals and passenger piers to measure the temperatures of passengers departing the city, according to state media.

China is also encouraging passengers traveling to and from Wuhan to change their travel plans during the busy Lunar New Year holiday period, by exempting them from service charges for refunds for all modes of transport.

How does this compare to the SARS virus?

Death rates

Scientists say the infectiousness of the virus is not as strong as SARS, but have added that the number of people infected is climbing.

A study by researchers in the UK estimated that the number of infections in Wuhan is still grossly underestimated, with the real number closer to 4,000 as of January 18, based on the spread of the virus to other cities and countries in a relatively short period of time.

SARS infected more than 8,000 people and killed 774 in a pandemic that ripped through Asia in 2002 and 2003.

The travel restrictions imposed on Wuhan were extended to at least four more cities. At least 18 people have died and more than 600 have been sickened by a mysterious illness, health officials said.

By The New York Times

RIGHT NOW

The authorities confirmed the first death outside of the virus’s epicenter, in a province more than 600 miles to the north. But the World Health Organization held off on declaring a global health emergency.

The committee had first planned to issue a recommendation on Wednesday about whether to declare an emergency (the decision ultimately falls to the W.H.O.’s director general). Such a declaration would give the W.H.O. broader authority to shape different countries’ responses. But committee members were split.

On Thursday, after news of Wuhan’s travel restrictions and the increased death count emerged, the committee met again, and decided not to recommend the declaration. Several members thought it was “still too early,” the W.H.O. said in a news release.

Agency officials explained that although the disease has reached beyond China, the number of cases in other countries is still relatively small, and the disease does not seem to be spreading within those countries.

“At this time, there is no evidence of human to human transmission outside China,” Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director general, said at a news conference in Geneva. “That doesn’t mean it won’t happen.”

“Make no mistake,” he said. “This is an emergency in China, but it has not yet become a global health emergency. It may yet become one.”

Only five global public health emergency declarations have been made in the past. The decisions are fraught, with health authorities wary of causing panic, or of suggesting that governments cannot handle outbreaks on their own.

Still, the W.H.O. called on the Chinese government to share more information on how it was handling the crisis.

Here are the latest images as the country confronts a major public health crisis.

Jan. 23, 2020

First death confirmed outside of virus epicenter

A patient died in the province of Hebei — more than 600 miles north of the city where the outbreak began — after contracting the new coronavirus, the provincial authorities announced on Thursday. It was the first confirmed death outside of the virus’s epicenter.

The victim was an 80-year-old man who had lived in the city of Wuhan, where the outbreak originated, for more than two months, according to Hebei’s provincial health department. Wuhan is a major port city of 11 million in the province of Hubei, where all of the 17 previously reported deaths have taken place.

The victim died on Wednesday, but officials did not confirm that he had died of the coronavirus until Thursday, the Hebei provincial announcement said.

The announcement did not say when the man had returned to Hebei Province from Wuhan, but said that he had developed chest tightness and difficulty breathing after his return. Like many of the other confirmed victims of the virus, he appeared to have other underlying health issues: After being admitted to a hospital, he also was treated for high blood pressure, chronic bronchitis and emphysema, the authorities said.

The authorities suspend travel from more cities, affecting millions.

The railway station in Wuhan on Thursday, where only a few passengers were debarking trains and residents were told that they could not board any.Credit…Chris Buckley/The New York Times

The authorities expanded travel restrictions to several Chinese cities near Wuhan hours after announcing that the death toll and number of cases had risen sharply. Currently, at least 18 victims have been confirmed dead and more than 600 infected, according to Chinese officials.

The restrictions on train and other forms of travel will apply to tens of millions of people and come just days before the Lunar New Year holiday, when hundreds of millions of people travel around and out of the country.

The Chinese authorities on Thursday morning closed off Wuhan by canceling flights and trains leaving the city, and suspending buses, subways and ferries within it. Late on Thursday, the local authorities also announced that they would suspend for-hire vehicles and limit taxis, beginning at noon on Friday.

Roughly 30,000 people fly out of Wuhan on an average day, according to air traffic data. Many more leave using ground transportation like trains and cars.

By evening, officials planned to also close off Huanggang, a city of seven million about 30 miles east of Wuhan, shut rail stations in the nearby city of Ezhou, which has about one million residents, and impose travel restrictions on the smaller cities of Chibi and Zhijiang.

In Huanggang, public transportation and departing trains stopped at midnight. Residents are not allowed to leave the city without special permission, according to a government statement. In Ezhou, all rail stations were to be closed.

Separately, the provincial authorities in Hubei announced late Thursday some restrictions for the entire province, not just specific cities. Travel agencies are prohibited from taking customers and organizing tours, for example, and business trips are being suspended.

Schools throughout the province, which have breaks scheduled for the Lunar New Year holiday, will postpone their post-break start dates indefinitely.

The new virus, which first emerged at the end of December, has sickened people in Taiwan, Vietnam, Japan, Thailand, Singapore, South Korea and the United States. It has raised the specter of a repeat of the SARS epidemic, which broke out in China in 2002 and 2003 and spread rapidly while officials obscured the seriousness of the crisis. That virus eventually killed more than 800 people worldwide.

In Beijing, the government said it would cancel large public gatherings for the holiday, including fairs at temples that usually draw shoulder-to-shoulder crowds, and the Forbidden City, a popular tourist attraction in the heart of the capital, will close starting on Saturday.

What is a coronavirus and how dangerous is it?

Paramedics taking a man believed to be Hong Kong’s first coronavirus patient to a hospital on Wednesday.Credit…Lam Yik Fei for The New York Times

Coronaviruses are named for the spikes that protrude from their membranes, which resemble the sun’s corona. They can infect both animals and people, and cause illnesses of the respiratory tract, ranging from the common cold to severe conditions like SARS.

Symptoms of infection include a high fever, difficulty breathing and lung lesions. Milder cases may resemble the flu or a bad cold, making detection difficult. The incubation period — the time from exposure to the onset of symptoms — is believed to be about two weeks.

While the headlines are alarming, health experts cautioned that it was too early to gauge the severity of the outbreak. There are too many unknowns: Where did it start? How easily does it spread? How does it compare to other coronaviruses, like SARS?

Dr. William Schaffner, a specialist in infectious diseases at Vanderbilt University Medical Center, said the illness should be viewed in perspective. While a new virus spreading internationally gets more attention, the much more common influenza virus is the bigger hazard for most people, he said.

“If I look at this winter respiratory season, influenza is going to cause many more illnesses and more deaths than this coronavirus,” he said. “It’s one of those circumstances where, if familiarity doesn’t breed contempt, it certainly breeds a certain nonchalance.”

Where is the virus spreading?

Maps: Where the Wuhan Coronavirus Has Spread

The virus has sickened hundreds of people in Asia and at least one person in the United States.

As anxiety about the virus has grown, governments around the world have taken precautions to isolate anyone displaying symptoms, though several cases have proved not to be the coronavirus.

Health officials in the United States said on Thursday that there could be a second infection in the country, after the authorities in Washington State confirmed earlier this week that a man there had fallen sick with the Wuhan coronavirus. The second possible patient was in Brazos County, Texas, where officials said they were keeping a patient isolated at home while they did additional testing.

Vietnam’s Ministry of Health announced on Thursday that it had confirmed two cases of the coronavirus, in two male Chinese patients.

In Mexico, two out of five potential coronavirus cases were officially ruled out by the Health Ministry on Thursday after comprehensive tests were conducted, according to state and federal government officials.

A health official said that one of the patients, a 57-year-old professor, had been diagnosed with a common cold.

The three other cases, in the western state of Jalisco, were under observation and were being tested, according to the Health Ministry report. The patients include a 42-year old man who returned to Mexico from Wuhan on Jan. 10, and two other women who had contact with him.

Residents in Wuhan are nervous. Some are also angry.

A supermarket in Wuhan on Thursday.Credit…Getty Images

Across Wuhan on Thursday, residents — some wearing masks, some sniffing or coughing — visited hospitals and clinics seeking treatment. In interviews with a New York Times correspondent in the city, some said they were angry about the sudden lockdown. Others said they were confused by the restrictions.

Outside the Wuhan No. 3 Hospital, Yang Lin, said she had come to the hospital to see if a sniffling cold she had might be the coronavirus. After a quick check, the doctors told her not to worry. But she was not reassured.

“They said it was just a common cold, and told me to get some medicine and go home,” Ms. Yang, 28, said. “But how am I to know? They didn’t even take my temperature. It’s just not responsible.”

The outbreak is testing Wuhan’s health care system. Several Wuhan residents said on social media websites that they had gone from hospital to hospital, waiting in lines for hours, only to be sent home with medicine and instructions to seek further treatment later if symptoms persisted in a few days.

Doctors told some patients that there was a shortage of hospital beds as well as testing kits, according to posts on Chinese social media sites.

China’s Ministry of Finance said on Thursday that it would allocate 1 billion yuan, or about $144 million, to officials in Hubei to fight the virus, though it did not specify how the money would be used.

Wuhan officials also said that they would construct a new hospital specifically for coronavirus patients. The new hospital was ordered built within six days, according to People’s Daily, the ruling Communist Party’s main newspaper.

Cheng Shidong, a doctor at the Zhongnan Hospital of Wuhan University, said in an interview that his hospital had set up 100 beds to receive infected patients, but that it didn’t have enough protective material, such as masks and suits, for the medical staff.

In Wuhan, Ms. Yang said that while she was in a pharmacy buying medicine, another person complained that he thought he had the coronavirus but had not been isolated. The city’s medical system, especially its smaller hospitals, seems unprepared for the influx of patients, she said.

“I’m willing to accept that we have to stay in Wuhan, O.K., but the medical care needs to keep up,” she said. “You shouldn’t tell us we can’t leave, and then give us second-rate medical care. That’s unfair.”

The first 17 people were largely older men, many with underlying health problems. All died in Hubei Province, which includes the city of Wuhan.

The first confirmed death was a 61-year-old man who went to a hospital in Wuhan on December 27, weak with a fever and a cough. He was transferred to another hospital as his condition worsened, and he was later attached to a machine that helped oxygenate his blood. But he died on Jan. 9.

Twelve of the other 17 deaths in Hubei were also men, and four were women, officials said. The youngest victim was a 48-year-old woman who died on Monday. The oldest were two 89-year-old men.

Separately on Thursday, the health authorities in Hebei Province, to the north of Hubei Province, announced that an 80-year-old man there had died, bringing the death count to 18.

Many of the victims had underlying conditions like cirrhosis of the liver, hypertension, diabetes and Parkinson’s disease. Most had gone to the hospital with a fever and a cough, though at least three had no fever when they were admitted, according to the health commission.

While a full picture of the virus is still unknown, medical experts found positive signs in the fact that the disease did not appear to be killing young and otherwise healthy people.

“The majority of fatal cases are elderly and/or have a chronic disease that would increase their susceptibility to infectious diseases,” said Dr. W. Ian Lipkin, an epidemiologist at the Mailman School of Public Health at Columbia University in New York.

‘I feel extremely powerless,’ says a SARS expert, raising an alarm.

In an unusually blunt interview, Dr. Guan Yi, a professor of infectious diseases in Hong Kong and expert on SARS, criticized the authorities in Wuhan for acting too slowly and obstructing his efforts to investigate the outbreak.

Dr. Guan, who helped successfully identify the coronavirus that caused SARS during the 2002-2003 outbreak in China, told the influential Chinese magazine Caixin that he was deeply frustrated by the city government’s response to the spread of the virus.

He and his team had visited Wuhan on Tuesday hoping that they could track the animal that was the source of the coronavirus but were shocked to find that residents at a market were not taking any precautions or wearing masks. No special measures were in place at the airport to disinfect surfaces and floors, either. This showed that the city government was being complacent despite the urgent orders handed down by Beijing, he said.

“I thought at the time, we had to be in a ‘state of war’, but how come the alarm has not been raised?” he told Caixin. “Poor citizens, they were still preparing to ring in the New Year in peace and had no sense about the epidemic.”

He also criticized the local authorities for disinfecting the market where many infections had been traced to, saying that made it difficult for researchers to investigate where the virus came from.

“I consider myself a veteran in battles,” he said, citing his experience with bird flu, SARS, and other outbreaks. “But with this Wuhan pneumonia, I feel extremely powerless.”

Some residents worry the government is underreporting cases.

Health officials in Beijing take passengers’ temperatures as they arrive on flights from Wuhan on Wednesday. Credit…Emily Wang/Associated Press

There are growing concerns that the Chinese authorities are underreporting the number of people who are ill with the virus. Relatives of patients say that some hospitals, strapped for resources as they deal with an influx of patients, are turning sick people away or refusing to test them for the coronavirus.

Many people remain skeptical of the government’s official statistics, with memories of the effort to cover up the severity of the SARS outbreak still fresh.

In Wuhan, Kyle Hui, an architect from Shanghai, said that doctors at Tongji Hospital declined to test his stepmother for the virus, even though she was showing symptoms like a cough and a fever. She died on Jan. 15 of “severe pneumonia,” according to a copy of her death certificate.

Mr. Hui said that hospital workers treated his stepmother as if she had the coronavirus, wearing hazmat suits. After she died, the hospital instructed the family to cremate the body immediately. Mr. Hui said that after her death, doctors informed the family that they suspected his stepmother had the coronavirus.

“I’m very sad my stepmother left without any dignity,” Mr. Hui said during an interview this week in a cafe in Wuhan. “There was no time to say goodbye.”

A New York Times reporter travels to the epidemic’s ground zero.

Patients waited to see doctors at Wuhan No. 9 Hospital on Thursday, where the medical staff were all wearing heavily protective clothing.Credit…Chris Buckley/The New York Times

Chris Buckley, our chief China correspondent, headed to Wuhan from Beijing to cover the outbreak. He is sending live dispatches from his trip.

11 A.M. — ABOARD THE G79 HIGH SPEED TRAIN

The G79 high speed train from Beijing to Hong Kong, which stops in Wuhan, was crowded with holiday passengers. The train was a hubbub of conversation, much of it about the deadly coronavirus and the lockdown around Wuhan.

Guo Jing, a worker from northeast China, was headed with two friends for a holiday in Macau. After some hesitation, they had taken off their masks. “They’re too uncomfortable inside,” Mr. Guo said. “My view is we have to be careful but not panic. If you’re the panicky type, then you wouldn’t be on this train.”

Half an hour out from Wuhan, the train is quite crowded with passengers. When I explain that I’m getting off at Wuhan, the reactions vary from advice — wear masks, don’t go, drink lots of water — to mordant jokes that I may be there a long time.

“You should know that they probably won’t let people out until the New Year holiday is over,” said one woman, who would only give her family name, Yang.

2:29 P.M. — WUHAN

Wuhan Railway Station, usually thronging with people in the days before the Lunar New Year holiday, is very empty. An announcement playing on a loop over the speakers tells the few people here that residents cannot leave the city and the station is temporarily closed.

Bats, badgers or bamboo rats? Scientists spar over possible causes

The Huanan Seafood Market in Wuhan, which has been linked to the new coronavirus, has been disinfected and closed.Credit…Getty Images

Scientists have been scrambling to understand the source of the coronavirus, in particular, the animals from which the virus may have jumped to humans. Many of the cases in Wuhan were connected to a market that sold live poultry and exotic animal meats. The market was closed and disinfected.

Early epidemiological research is indicating that it may have come from wild animals such as bamboo rats and badgers, said Dr. Zhong Nanshan, a prominent Chinese scientist who was the country’s leading expert during the SARS outbreak, during an interview with state media on Monday. Named for its bamboo-heavy diet, the cat-sized bamboo rat has become a somewhat popular delicacy in recent years in China, promoted for its purported health properties.

A group of Chinese researchers from the eastern city of Tianjin and Nanjing in the south, said the Wuhan coronavirus may have originated from Chinese horseshoe bats, according to a study they published in the Chinese Journal of Bioinformatics on Tuesday.

China’s National Genomics Data Center said the Wuhan virus was 88 percent genetically similar to a SARS-like coronavirus that was collected from bats in China in 2017.

Still another group of Chinese scientists suggested that snakes were the “most probable wildlife animal reservoir” for the novel coronavirus, then transmitted to humans, in an article published in the Journal of Medical Virology Wednesday.

But that assessment immediately drew fire from the international health community.

The study’s lead author, Wei Ji of the Peking University Health Science Center School of Basic Medical Sciences, did not actually find the new coronavirus in a snake, noted David Robertson, a professor at the University of Glasgow. Instead, Dr. Ji and his colleagues compared the genomes of an assortment of viruses and hosts and claimed to find a similarity between the genomes of the new virus and snakes.

Dr. Ji did not respond to an email query by the time of publication.

Many residents tried to leave the city.

Hankou Railway Station in Wuhan on Wednesday, before the authorities said they would cancel planes and trains leaving the city.Credit…Xiaolu Chu/Getty Images

The announcement that the city of Wuhan would be temporarily sealed off from the outside world starting at 10 a.m. on Thursday came while most residents were asleep at 2 a.m.

Some decided to flee the city.

Residents were seen hauling their luggage to a train station in the early hours before the citywide lockdown took effect, the Chinese news outlet Caixin reported. Several people said they would buy tickets for any destination as long as they could leave Wuhan, the magazine reported.

Lines of passengers in masks and down jackets, lugging suitcases, formed outside the major Hankou railway station just 20 minutes before the cutoff time, a live video by media outlet The Paper showed.

Han Zhen and Wang Mengkai, two migrant workers from Henan Province, said they had rushed to the railway station in order to leave on Wednesday night, but missed the last train out.

Both said they were frustrated by the sudden lockdown and were scrambling to find a way home.

“It’s serious but not that serious,” said Mr. Wang, who works in an electronics parts factory. “We’re trying to figure out how we can get home. If we can’t get out on a train, we’ll try putting together a car with a driver.”

Asked if they were motivated to leave by fear of the virus, Mr. Han said: “No, we are not scared.”

Introduction to viruses

This article is a non-technical introduction to the subject. For the main encyclopedia article, see Virus.

A rotavirus

A virus is a biological agent that reproduces inside the cells of living hosts. When infected by a virus, a host cell is forced to produce thousands of identical copies of the original virus at an extraordinary rate. Unlike most living things, viruses do not have cells that divide; new viruses are assembled in the infected host cell. But unlike still simpler infectious agents, viruses contain genes, which gives them the ability to mutate and evolve. Over 5,000 species of viruses have been discovered.[1]

The origins of viruses are unclear: some may have evolved from plasmids—pieces of DNA that can move between cells—while others may have evolved from bacteria. A virus consists of two or three parts: genes, made from either DNA or RNA, long molecules that carry genetic information; a protein coat that protects the genes; and in some viruses, an envelope of fat that surrounds the protein coat and is used, in combination with specific receptors, to enter a new host cell. Viruses vary in shape from the simple helical and icosahedral to more complex structures. Viruses range in size from 20 to 300 nanometres; it would take 33,000 to 500,000 of them, side by side, to stretch to 1 centimetre (0.39 in).

Viruses spread in many ways. Just as many viruses are very specific as to which host species or tissue they attack, each species of virus relies on a particular method for propagation. Plant viruses are often spread from plant to plant by insects and other organisms, known as vectors. Some viruses of animals, including humans, are spread by exposure to infected bodily fluids. Viruses such as influenza are spread through the air by droplets of moisture when people cough or sneeze. Viruses such as norovirus are transmitted by the faecal–oral route, which involves the contamination of hands, food and water. Rotavirus is often spread by direct contact with infected children. The human immunodeficiency virus, HIV, is transmitted by bodily fluids transferred during sex. Others, such as the Dengue virus, are spread by blood-sucking insects.

Viral infections can cause disease in humans, animals and even plants. However, they are usually eliminated by the immune system, conferring lifetime immunity to the host for that virus. Antibiotics have no effect on viruses, but antiviral drugs have been developed to treat life-threatening infections. Vaccines that produce lifelong immunity can prevent some viral infections.

Contents

Discovery

In 1884 the French microbiologistCharles Chamberland invented a filter, known today as the Chamberland filter or Chamberland–Pasteur filter, that has pores smaller than bacteria. Thus he could pass a solution containing bacteria through the filter and completely remove them from the solution.[2] In the early 1890s the Russian biologistDmitri Ivanovsky used this filter to study what became known as the tobacco mosaic virus. His experiments showed that extracts from the crushed leaves of infected tobacco plants remain infectious after filtration.

At the same time several other scientists proved that, although these agents (later called viruses) were different from bacteria, they could still cause disease, and they were about one hundredth the size of bacteria. In 1899 the Dutch microbiologist Martinus Beijerinck observed that the agent multiplied only in dividing cells. Having failed to demonstrate its particulate nature, he called it a “contagium vivum fluidum“, a “soluble living germ”.[3] In the early 20th century the English bacteriologistFrederick Twort discovered viruses that infect bacteria,[4] and the French-Canadian microbiologist Félix d’Herelle described viruses that, when added to bacteria growing on agar, would lead to the formation of whole areas of dead bacteria. Counting these dead areas allowed him to calculate the number of viruses in the suspension.[5]

Origins

Viruses co-exist with life wherever it occurs. They have probably existed since living cells first evolved. The origin of viruses remains unclear because they do not form fossils, so molecular techniques have been the most useful means of hypothesising how they arose. However, these techniques rely on the availability of ancient viral DNA or RNA but most of the viruses that have been preserved and stored in laboratories are less than 90 years old.[12][13] Molecular methods have only been successful in tracing the ancestry of viruses that evolved in the 20th century.[14] New groups of viruses might have repeatedly emerged at all stages of the evolution of life.[15] Three main theories speculate on the origins of viruses:[15][16]

Regressive theory

Viruses may have once been small cells that parasitised larger cells. Over time, genes not required by their parasitism were lost. The bacteria rickettsia and chlamydia are living cells that, like viruses, can reproduce only inside host cells. They lend credence to this theory, as their dependence on parasitism is likely to have caused the loss of genes that enabled them to survive outside a cell.[17]

Cellular origin theory

Some viruses may have evolved from bits of DNA or RNA that “escaped” from the genes of a larger organism. The escaped DNA could have come from plasmids—pieces of DNA that can move between cells—while others may have evolved from bacteria.[18]

Coevolution theory

Viruses may have evolved from complex molecules of protein and DNA at the same time as cells first appeared on earth and would have depended on cellular life for many millions of years.[19]

There are problems with all of these hypotheses: the regressive hypothesis does not explain why even the smallest of cellular parasites do not resemble viruses in any way. The escape hypothesis does not explain the structures of virus particles. The coevolution, or virus-first hypothesis, contravenes the definition of viruses, in that they are dependent on host cells.[19] But viruses are recognised as ancient and to have origins that pre-date the divergence of life into the three domains.[20] This discovery has led modern virologists to reconsider and re-evaluate these three classical hypotheses.[20][15]

Structure

A simplified diagram of the structure of a virus

A virus particle, also known as a virion, consists of genes made from DNA or RNA which are surrounded by a protective coat of protein called a capsid.[21] The capsid is made of many smaller, identical protein molecules which are called capsomers. The arrangement of the capsomers can either be icosahedral (20-sided), helical or more complex. There is an inner shell around the DNA or RNA called the nucleocapsid, which is formed by proteins. Some viruses are surrounded by a bubble of lipid (fat) called an envelope.

Size

Viruses are among the smallest infectious agents, and most of them can only be seen by electron microscopy. Most viruses cannot be seen by light microscopy (in other words, they are sub-microscopic); their sizes range from 20 to 300 nm. They are so small that it would take 30,000 to 750,000 of them, side by side, to stretch to one cm.[21] By contrast bacterial sizes are typically around 1 micrometre (1000 nm) in diameter, and the cells of higher organisms a few tens of micrometres. Some viruses such as megaviruses and pandoraviruses are relatively large. At around 1 micrometer, these viruses, which infect amoebae, were discovered in 2003 and 2013. They are around a thousand times larger than influenza viruses and the discovery of these “giant” viruses astonished scientists.[22]

Genes

Genes are made from DNA (deoxyribonucleic acid) and, in many viruses, RNA (ribonucleic acid). The biological information contained in an organism is encoded in its DNA or RNA. Most organisms use DNA, but many viruses have RNA as their genetic material. The DNA or RNA of viruses consists of either a single strand or a double helix.[23]

Viruses reproduce rapidly because they have only a few genes compared to humans who have 20,000–25,000.[24] For example, influenza virus has only eight genes and rotavirus has eleven. These genes encode structural proteins that form the virus particle, or non-structural proteins, that are only found in cells infected by the virus.[25]

All cells, and many viruses, produce proteins that are enzymes called DNA polymerase and RNA polymerase which make new copies of DNA and RNA. A virus’s polymerase enzymes are often much more efficient at making DNA and RNA than the host cell’s.[26] However, RNA polymerase enzymes often make mistakes, and this is one of the reasons why RNA viruses often mutate to form new strains.[27]

In some species of RNA virus, the genes are not on a continuous molecule of RNA, but are separated. The influenza virus, for example, has eight separate genes made of RNA. When two different strains of influenza virus infect the same cell, these genes can mix and produce new strains of the virus in a process called reassortment.[28]

Proteins are essential to life. Cells produce new protein molecules from amino acid building blocks based on information coded in DNA. Each type of protein is a specialist that usually only performs one function, so if a cell needs to do something new, it must make a new protein. Viruses force the cell to make new proteins that the cell does not need, but are needed for the virus to reproduce. Protein synthesis consists of two major steps: transcription and translation.

Transcription is the process where information in DNA, called the genetic code, is used to produce RNA copies called messenger RNA (mRNA). These migrate through the cell and carry the code to ribosomes where it is used to make proteins. This is called translation because the protein’s amino acid structure is determined by the mRNA’s code. Information is hence translated from the language of nucleic acids to the language of amino acids.

Some nucleic acids of RNA viruses function directly as mRNA without further modification. For this reason, these viruses are called positive-sense RNA viruses.[29] In other RNA viruses, the RNA is a complementary copy of mRNA and these viruses rely on the cell’s or their own enzyme to make mRNA. These are called negative-sense RNA viruses. In viruses made from DNA, the method of mRNA production is similar to that of the cell. The species of viruses called retroviruses behave completely differently: they have RNA, but inside the host cell a DNA copy of their RNA is made with the help of the enzyme reverse transcriptase. This DNA is then incorporated into the host’s own DNA, and copied into mRNA by the cell’s normal pathways.[30]

Life-cycle

Life-cycle of a typical virus (left to right); following infection of a cell by a single virus, hundreds of offspring are released.

When a virus infects a cell, the virus forces it to make thousands more viruses. It does this by making the cell copy the virus’s DNA or RNA, making viral proteins, which all assemble to form new virus particles.[31]

There are six basic, overlapping stages in the life cycle of viruses in living cells:[32]

Attachment is the binding of the virus to specific molecules on the surface of the cell. This specificity restricts the virus to a very limited type of cell. For example, the human immunodeficiency virus (HIV) infects only human T cells, because its surface protein, gp120, can only react with CD4 and other molecules on the T cell’s surface. Plant viruses can only attach to plant cells and cannot infect animals. This mechanism has evolved to favour those viruses that only infect cells in which they are capable of reproducing.

Penetration follows attachment; viruses penetrate the host cell by endocytosis or by fusion with the cell.

Uncoating happens inside the cell when the viral capsid is removed and destroyed by viral enzymes or host enzymes, thereby exposing the viral nucleic acid.

Replication of virus particles is the stage where a cell uses viral messenger RNA in its protein synthesis systems to produce viral proteins. The RNA or DNA synthesis abilities of the cell produce the virus’s DNA or RNA.

Assembly takes place in the cell when the newly created viral proteins and nucleic acid combine to form hundreds of new virus particles.

Release occurs when the new viruses escape or are released from the cell. Most viruses achieve this by making the cells burst, a process called lysis. Other viruses such as HIV are released more gently by a process called budding.

Effects on the host cell[

The range of structural and biochemical effects that viruses have on the host cell is extensive.[33] These are called cytopathic effects.[34] Most virus infections eventually result in the death of the host cell. The causes of death include cell lysis (bursting), alterations to the cell’s surface membrane and apoptosis (cell “suicide”).[35] Often cell death is caused by cessation of its normal activity due to proteins produced by the virus, not all of which are components of the virus particle.[36]

Some viruses cause no apparent changes to the infected cell. Cells in which the virus is latent and inactive show few signs of infection and often function normally.[37] This causes persistent infections and the virus is often dormant for many months or years. This is often the case with herpes viruses.[38][39]

Some viruses, such as Epstein-Barr virus, often cause cells to proliferate without causing malignancy;[40] but some other viruses, such as papillomavirus, are an established cause of cancer.[41] When a cell’s DNA is damaged by a virus, and if the cell cannot repair itself, this often triggers apoptosis. One of the results of apoptosis is destruction of the damaged DNA by the cell itself. Some viruses have mechanisms to limit apoptosis so that the host cell does not die before progeny viruses have been produced; HIV, for example, does this.[35]

Viruses and diseases

Norovirus. Ten Norovirus particles; this RNA virus causes winter vomiting disease. It is often in the news as a cause of gastro-enteritis on cruise ships and in hospitals.

Common human diseases caused by viruses include the common cold, the flu, chickenpox and cold sores. Serious diseases such as Ebola and AIDS are also caused by viruses. Many viruses cause little or no disease and are said to be “benign”. The more harmful viruses are described as virulent. Viruses cause different diseases depending on the types of cell that they infect. Some viruses can cause lifelong or chronic infections where the viruses continue to reproduce in the body despite the host’s defence mechanisms.[42] This is common in hepatitis B virus and hepatitis C virus infections. People chronically infected with a virus are known as carriers. They serve as important reservoirs of the virus. If there is a high proportion of carriers in a given population, a disease is said to be endemic.[43]

There are many ways in which viruses spread from host to host but each species of virus uses only one or two. Many viruses that infect plants are carried by organisms; such organisms are called vectors. Some viruses that infect animals, including humans, are also spread by vectors, usually blood-sucking insects. However, direct transmission is more common. Some virus infections, such as norovirus and rotavirus, are spread by contaminated food and water, hands and communal objects and by intimate contact with another infected person, while others are airborne (influenza virus). Viruses such as HIV, hepatitis B and hepatitis C are often transmitted by unprotected sex or contaminated hypodermic needles. It is important to know how each different kind of virus is spread to prevent infections and epidemics.[44]

Diseases of plants

There are many types of plant virus, but often they only cause a loss of yield, and it is not economically viable to try to control them. Plant viruses are often spread from plant to plant by organisms (vectors). These are normally insects, but some fungi, nematode worms and single-celled organisms have been shown to be vectors. When control of plant virus infections is considered economical (perennial fruits, for example) efforts are concentrated on killing the vectors and removing alternate hosts such as weeds.[45] Plant viruses are harmless to humans and other animals because they can only reproduce in living plant cells.[46]

Bacteriophages

Bacteriophages are viruses that infect bacteria and archaea. The International Committee on Taxonomy of Viruses officially recognises 28 genera of bacteriophages that belong to 11 families.[47] They are important in marine ecology: as the infected bacteria burst, carbon compounds are released back into the environment, which stimulates fresh organic growth. Bacteriophages are useful in scientific research because they are harmless to humans and can be studied easily. These viruses can be a problem in industries that produce food and drugs by fermentation and depend on healthy bacteria. Some bacterial infections are becoming difficult to control with antibiotics, so there is a growing interest in the use of bacteriophages to treat infections in humans.[48]

Host resistance

Innate immunity of animals

Animals, including humans, have many natural defences against viruses. Some are non-specific and protect against many viruses regardless of the type. This innate immunity is not improved by repeated exposure to viruses and does not retain a “memory” of the infection. The skin of animals, particularly its surface, which is made from dead cells, prevents many types of viruses from infecting the host. The acidity of the contents of the stomach destroys many viruses that have been swallowed. When a virus overcomes these barriers and enters the host, other innate defences prevent the spread of infection in the body. A special hormone called interferon is produced by the body when viruses are present, and this stops the viruses from reproducing by killing the infected cell and its close neighbours. Inside cells, there are enzymes that destroy the RNA of viruses. This is called RNA interference. Some blood cells engulf and destroy other virus infected cells.[49]

Adaptive immunity of animals

Two rotavirus particles: the one on the right is coated with antibodies which stop its attaching to cells and infecting them

Specific immunity to viruses develops over time and white blood cells called lymphocytes play a central role. Lymphocytes retain a “memory” of virus infections and produce many special molecules called antibodies. These antibodies attach to viruses and stop the virus from infecting cells. Antibodies are highly selective and attack only one type of virus. The body makes many different antibodies, especially during the initial infection; however, after the infection subsides, some antibodies remain and continue to be produced, often giving the host lifelong immunity to the virus.[50]

Plant resistance

Plants have elaborate and effective defence mechanisms against viruses. One of the most effective is the presence of so-called resistance (R) genes. Each R gene confers resistance to a particular virus by triggering localised areas of cell death around the infected cell, which can often be seen with the unaided eye as large spots. This stops the infection from spreading.[51] RNA interference is also an effective defence in plants.[52] When they are infected, plants often produce natural disinfectants which destroy viruses, such as salicylic acid, nitric oxide and reactive oxygen molecules.[53]

Resistance to bacteriophages

The major way bacteria defend themselves from bacteriophages is by producing enzymes which destroy foreign DNA. These enzymes, called restriction endonucleases, cut up the viral DNA that bacteriophages inject into bacterial cells.

Prevention and treatment of viral disease in humans and other animals[edit]

Vaccines

The structure of DNA showing the position of the nucleosides and the phosphorus atoms that form the “backbone” of the molecule

Vaccination is a way of preventing diseases caused by viruses. Vaccines simulate a natural infection and its associated immune response, but do not cause the disease. Their use has resulted in the eradication of smallpox and a dramatic decline in illness and death caused by infections such as polio, measles, mumps and rubella.[54] Vaccines are available to prevent over fourteen viral infections of humans[55] and more are used to prevent viral infections of animals.[56] Vaccines may consist of either live or killed viruses.[57] Live vaccines contain weakened forms of the virus, but these vaccines can be dangerous when given to people with weak immunity. In these people, the weakened virus can cause the original disease.[58] Biotechnology and genetic engineering techniques are used to produce “designer” vaccines that only have the capsid proteins of the virus. Hepatitis B vaccine is an example of this type of vaccine.[59] These vaccines are safer because they can never cause the disease.[57]

Antiviral drugs

Since the mid 1980s, the development of antiviral drugs has increased rapidly, mainly driven by the AIDS pandemic. Antiviral drugs are often nucleoside analogues, which are molecules very similar, but not identical to DNA building blocks. When the replication of virus DNA begins, some of these fake building blocks are incorporated. As soon as that happens, replication stops prematurely—the fake building blocks lack the essential features that allow the addition of further building blocks. Thus, DNA production is halted, and the virus can no longer reproduce.[60] Examples of nucleoside analogues are aciclovir for herpes virus infections and lamivudine for HIV and hepatitis B virus infections. Aciclovir is one of the oldest and most frequently prescribed antiviral drugs.[61]

Other antiviral drugs target different stages of the viral life cycle. HIV is dependent on an enzyme called the HIV-1 protease for the virus to become infectious. There is a class of drugs called protease inhibitors, which bind to this enzyme and stop it from functioning.[62]

Hepatitis C is caused by an RNA virus. In 80% of people infected, the disease becomes chronic, and they remain infectious for the rest of their lives unless they are treated. There is an effective treatment that uses the nucleoside analogue drug ribavirin combined with interferon.[63] Treatments for chronic carriers of the hepatitis B virus by a similar strategy using lamivudine and other anti-viral drugs have been developed.[64] In both diseases, the drugs stop the virus from reproducing and the interferon kills any remaining infected cells.

HIV infections are usually treated with a combination of antiviral drugs, each targeting a different stage in the virus’s life-cycle. There are drugs that prevent the virus from attaching to cells, others that are nucleoside analogues and some poison the virus’s enzymes that it needs to reproduce.[62] The success of these drugs is proof of the importance of knowing how viruses reproduce.

Role in ecology

Viruses are the most abundant biological entity in aquatic environments[65]—there are about one million of them in a teaspoon of seawater[66]—and they are essential to the regulation of saltwater and freshwater ecosystems.[67] Most of these viruses are bacteriophages, which are harmless to plants and animals. They infect and destroy the bacteria in aquatic microbial communities and this is the most important mechanism of recycling carbon in the marine environment. The organic molecules released from the bacterial cells by the viruses stimulate fresh bacterial and algal growth.[68]

Microorganisms constitute more than 90% of the biomass in the sea. It is estimated that viruses kill approximately 20% of this biomass each day and that there are fifteen times as many viruses in the oceans as there are bacteria and archaea. Viruses are mainly responsible for the rapid destruction of harmful algal blooms,[69] which often kill other marine life.[70] The number of viruses in the oceans decreases further offshore and deeper into the water, where there are fewer host organisms.[71]

Their effects are far-reaching; by increasing the amount of respiration in the oceans, viruses are indirectly responsible for reducing the amount of carbon dioxide in the atmosphere by approximately 3 gigatonnes of carbon per year.[71]

Marine mammals are also susceptible to viral infections. In 1988 and 2002, thousands of harbour seals were killed in Europe by phocine distemper virus.[72] Many other viruses, including caliciviruses, herpesviruses, adenoviruses and parvoviruses, circulate in marine mammal populations.[71]

An outbreak of the novel coronavirus 2019-nCoV was initially identified during mid-December 2019 in the city of Wuhan in central China, as an emerging cluster of people with pneumonia with no clear cause, which was linked primarily to stallholders who worked at the Huanan Seafood Market, which also sold live animals. Chinese scientists subsequently isolated a new strain of the coronavirus – given the initial designation of 2019-nCoV – which has been found to be at least 70 percent similar in genome sequence to SARS-CoV. With the development of a specific diagnostic PCR test for detecting the infection, a number of cases were confirmed in people directly linked to the market and in those who were not directly associated with it. Whether this virus is of the same severity or lethality as SARS is unclear.[13][14][15][16]

The first suspected cases were reported on 31 December 2019,[28] with the first instances of symptomatic illness appearing just over three weeks earlier on 8 December 2019.[29] The market was closed off on 1 January 2020, and people who showed signs and symptoms of the coronavirus infection were isolated.[28] Over 700 people, including more than 400 healthcare workers who came into close contact with possibly infected individuals, were initially monitored.[30] After the development of a specific diagnostic PCR test for detecting the infection, the presence of 2019-nCoV was subsequently confirmed in 41 people in the original Wuhan cluster,[13][31] of which two were later reported to be a married couple, one of whom had not been present in the marketplace, and another three who were members of the same family that worked at the marketplace’s seafood stalls.[32][33] The first confirmed death from the coronavirus infection occurred on 9 January 2020.[34]

On 23 January 2020, Wuhan was placed under quarantine, in which all public transport in and out of Wuhan have been suspended.[35] The cities of Huanggang, Ezhou, Chibi and Zhijiang, adjacent to Wuhan, will also be placed under a similar quarantine from 24 January 2020 onwards.[36][37]

Contents

As the inaugural cluster of cases with “pneumonia of unknown cause” was linked to a wholesale animal and fish market, which had a thousand stalls selling chickens, pheasants, bats, marmots, venomous snakes, spotted deer and the organs of rabbits and other wild animals (Ye wei), i.e. bushmeat, the immediate hypothesis was that this was a novel coronavirus from an animal source.[14][38][39][40]

Coronaviruses mainly circulate among animals, but have been known to evolve and infect humans, as has been seen with SARS, MERS and four other coronaviruses found in humans which cause mild respiratory symptoms like in the common cold. All six can spread from human to human.[41][42] In 2002, with an origin in civethorseshoe bats from live animal markets, an outbreak of SARS started in mainland China, and with the help of a few super-spreaders and international air travel, reached as far as Canada and the United States, resulting in over 700 deaths worldwide. The last case occurred in 2004.[41][43][44] At the time, China was criticised by the WHO for its handling of the epidemic.[45] Ten years after the onset of SARS, the dromedary-camel-related coronavirus, MERS, resulted in 750 deaths in over 27 countries.[41] The Wuhan outbreak’s association with a large seafood and animal market, has led to the presumption of the illness having an animal source.[42] This has resulted in the fear that it would be similar to the previous SARS outbreak,[43][46] a concern exacerbated by the expectation of a high numbers of travelers for Chinese New Year, which begins on 25 January 2020.[47]

Wuhan is the capital of Hubei province and is the seventh-largest city in China, with a population of more than 11 million people. It is a major transportation hub of the country, long known in China as “Nine Provinces’ Thoroughfare” (九省通衢). It is approximately 700 miles (1,100 km) south of Beijing,[48] 500 miles (800 km) west of Shanghai, and 600 miles (970 km) north of Hong Kong.[49] It is considered today as the political, economic, financial, commercial, cultural and educational center of Central China. Direct flights from Wuhan also connect with Europe: six flights weekly to Paris, three weekly to London, and five weekly to Rome.[50]

On 22 January 2020, scientists from Peking University, Guangxi Traditional Chinese Medical University, Ningbo University and Wuhan Biology Engineering College published an article, concluded that snakes were the most likely natural reservoir for the 2019-nCoV.[55][56] This is disputed by some other scientists, who argue that the wildlife reservoir must be bird or mammal.[56]

Confirmed cases outside of mainland China include three women and one man in Thailand, one man in Japan, one woman in South Korea, one woman in Taiwan, two men in Hong Kong, two men in Vietnam, one nurse in Saudi Arabia, one man in Singapore, one man in Macau and one man in the United States.[10][57][58][59][25] The figures are supported by experts including Michael Osterholm.[60]

On 17 January, an Imperial College group in the UK published an estimate that there had been 1,723 cases (95% confidence interval, 427–4,471) with onset of symptoms by 12 January 2020. This was based on the pattern of the initial spread to Thailand and Japan. They also concluded that “self-sustaining human-to-human transmission should not be ruled out”.[61][62] As further cases came to light, they later recalculated that “4,000 cases of 2019-nCoV in Wuhan City… had onset of symptoms by 18th January 2020”.[18][20] A Hong Kong University group has reached a similar conclusion as the earlier study, with additional detail on transport within China.[63]

On 20 January, China reported a sharp rise in cases with nearly 140 new patients, including two people in Beijing and one in Shenzhen.[64] As of 23 January, the number of laboratory-confirmed cases stands at 650, including 633 in Mainland China, 4 in Thailand, 3 in Hong Kong, 2 in Macau, 2 in Vietnam, one in Japan, one in South Korea, one in Taiwan, one in Saudi Arabia, one in Singapore and one in the United States.[12][65][66][67][68][69]

Chinese government announced at 23:00 (UTC+8) 23 January to shut down Chibi City effective at 00:00 on 24 January, preceded by the prefecture-level cities of Huanggang, Ezhou, and Wuhan.[70]

Reportedly, Wuhan City government has demanded a state-owned enterprise (中建三局集团) to re-construct an accommodation in Wuhan into a Virus Therapy Center at the fastest speed comparable to that during the SARS outbreak in 2003.[71]

An epidemiologist and SARS virologist with teams consisting of medical specialists who just flew back to Hong Kong after their one-day inspection in Wuhan told correspondants that the Wuhan Outbreak is at least 10 times larger than that of SARS, calling people to stay away from Wuhan as soon as possible.[72][73][74][75]

Some posts on Weibo showed that hospital in Wuhan has already overloaded with thousands of people with fever and were highly critical of the reliability of the figures from the Chinese government although such posts are now deleted due to unknown reasons.[76]

Since 31 December 2019, some regions and countries near China tightened their screening of selected travellers.[16] The US Centers for Disease Control and Prevention (CDC) later issued a Level 1 travel watch.[38][77] Guidances and risk assessments were shortly posted by others including the European Centre for Disease Prevention and Control and Public Health England.[78] In China, airports, railway stations and coach stations installed infrared thermometers. People with fevers are subsequently taken to medical institutions after being registered and given masks.[65]

Top 20 flight routes from Wuhan with data on the Infectious Disease Vulnerability Index for each country

An analysis of air travel patterns was used to map out and predict patterns of spread, and was published in the Journal of Travel Medicine in mid-January 2020. Based on information from the International Air Transport Association (2018), Bangkok, Hong Kong, Tokyo, and Taipei had the largest volume of travellers from Wuhan. Dubai in the United Arab Emirates and Sydney and Melbourne in Australia were also reported as popular destinations for people traveling from Wuhan. Using the validated tool, the Infectious Disease Vulnerability Index (IDVI), to assess ability of managing a disease threat, Bali was reported as least able in preparedness, while cities in Australia were most able.[29][79]

Hong Kong’s Centre for Health Protection (CHP) added the term “unidentified pneumonia” to their list of notifiable diseases to expand their authority on quarantine. The Hong Kong government also shortened hospital visits and made it a requirement for visitors to wear face masks. Screening was tightened at airports and train stations with connections to Wuhan.[44] In the first week of 2020, 30 unwell travelers from Wuhan were tested. Most were found to be positive for other respiratory viruses.[77][80] On 22 January 2020, a mainlander man, age 39, who traveled from Shenzhen developed symptoms of pneumonia. The man had been to Wuhan in the previous month. He tested positive for 2019-nCoV and was hospitalised in the Queen Elizabeth Hospital in Kowloon. A 56-year old man from Ma On Shan, who had visited Wuhan, had also tested positive for 2019-nCoV, raising the number of confirmed cases to two.[5][81]

The Hong Kong government designated the Lady MacLehose Holiday Village in Sai Kung as a quarantine centre. On 23 January 2020, three people who had come into close contact with the two aforementioned cases were quarantined, including two medical workers and a visitor from Australia.[82]

A 30-year-old Chinese national who had previously travelled to Wuhan developed a fever on 3 January 2020 and subsequently returned to Japan on 6 January. He tested positive for 2019-nCoV during a hospital admission between 10 and 15 January 2020. He had not visited the Huanan Seafood Market, but possibly had close contact with an affected person in Wuhan.[58][83]

Singapore’s Ministry of Health (MOH) issued a health advisory on the pneumonia outbreak on 2 January 2020, and implemented temperature checks for passengers arriving in Changi Airport from Wuhan the following day.[84] On 20 January 2020, temperature screening at Changi Airport was extended to all travellers coming from China. In addition, individuals with pneumonia who had travelled to Wuhan within 14 days before the onset of symptoms will be isolated in hospital. MOH also issued a reminder to hospitals and general practitioners to be vigilant for cases with pneumonia who have recently traveled to Wuhan.[85][86] On 22 January, quarantine measures were extended to travelers who arrived from China and display symptoms.[87] Three more suspected cases were detected on 22 January 2020. At the same time, the MOH began to form a multi-ministry taskforce to tackle the virus. The MOH also advised against non-essential trips to Wuhan[88] and later expanded the travel advisory to the whole of Hubei.[89]

The first case was confirmed on 23 January 2020 involving a 66-year-old China national from Wuhan who flew from Guangzhou via China Southern Airlines flight CZ351 with 9 companions and stayed at Shangri-La’s Rasa Sentosa Resort and Spa. Contact tracing of the hotel staff and flight passengers has begun.[90] Preliminary tests also showing positive results for a 53-year-old. Another 28 suspected cases were detected as a result of enhanced testing. Border control measures were enhanced and extended to land and sea checkpoints from 24 January 2020.[9]

On 21 January 2020, the first case in Taiwan was confirmed in a 50-year-old woman who just returned to Taoyuan International Airport from her teaching job in Wuhan.[11] She reported her signs to the patrols on her own initiative and was then sent hospitalised upon arrival without formal domestic entry and is being treated in quarantine.[11]

Among the 4 suspected cases reported, 3 have been tested negative in the initial screenings.[38][77][92]

In Thailand, screening passengers arriving from Wuhan at four different airports began on 3 January 2020, and a number of suspected cases have been found to have other common respiratory conditions.[59][93]

On 13 January 2020, Thailand witnessed the first confirmed case of 2019-nCoV outside China. The affected individual was a 61-year-old Chinese woman who is a resident of Wuhan; she had not visited the Huanan Seafood Market, but was noted to have been to other markets. She developed a sore throat, fever, chills and a headache on 5 January, flew directly with her family and a tour group from Wuhan to Suvarnabhumi airport in Bangkok on 8 January, where she was detected using thermal surveillance and was hospitalised that same day. Four days later, using RT-PCR, she tested positive for the new coronavirus.[29][94][95][94]

Thailand’s second case occurred in a 74-year-old woman who arrived in Bangkok on a flight from Wuhan on 17 January.[57]

On 21 January 2020, an 18-year-old male patient suspected who arrived in Chiang Mai from Wuhan was hospitalized with a high fever. Blood samples were sent to Bangkok for further analysis.[96][97]

On 22 January 2020, the Thai Ministry of Public Health announced a report for two additional confirmed cases of infection found in Thailand. The third was a 68-year-old man, a Chinese tourist like previous cases. The fourth was a 73-year-old Thai woman, who had returned from Wuhan, the first case for Thai citizen.[98][99]

Two suspected cases of pneumonia were detected on 14 January 2020 after two Chinese tourists arrived in Vietnam through Da Nang International Airport with a fever. The tourists were quarantined, and later released after having tested negative for the virus.[106]

The first two cases of confirmed infected were hospitalized on 22 January and treated at Cho Ray Hospital, Ho Chi Minh City. One case is a Chinese man travelling from Wuhan to Hanoi to visit his son living in Vietnam. The second is the man’s son who is believed to have contracted the disease from his father.[110]

The Health Secretary of the state of Minas Gerais reported on 22 January a suspected case from a 35 year old Brazilian woman who arrived in Belo Horizonte on 18 January from Shanghai, who self-reportedly did not visit Wuhan. Medical tests are underway to confirm the case.[111][112]

The Canada Border Services Agency (CBSA) has implemented signage in Toronto, Vancouver and Montreal airports to raise awareness of the virus and has added a health screening question to the electronic kiosks for passengers arriving from central China; however, there are no direct flights from Wuhan to Canada.[113][114]

As of 22 January, six people were put under observation in Quebec after showing signs of a respiratory virus since recently returning from China.[115] On the following day, the Minister of HealthPatty Hajdu said that five or six people were being monitored for signs of coronavirus, including at least one person in Quebec and another in Vancouver.[116]

One suspected case involved a five-year old child from Wuhan who had arrived in Cebu City on 12 January 2020. Samples from the child were sent to the Research Institute for Tropical Medicine in Muntinlupa for testing. The case tested positive for a “non-specific pancorona virus”, although it has yet to be determined if the pathogen is the 2019-nCoV.[120]

Samples from the child had been sent to a laboratory in Australia for further testing and the authorities are awaiting the results. Three other travellers from China were checked by authorities at another airport, but they did not show symptoms that corresponded with the warning issued by the World Health Organization about the virus from Wuhan.[121] Another two suspected cases tested negative for the virus, and were allowed to return home.[122]

Four suspected cases underwent testing in Scotland on 23 January: three in Edinburgh and one in Glasgow. All had recently been to Wuhan.[125]Heathrow Airport has tightened surveillance of the three direct flights that it receives from Wuhan every week. Each of these flights will be met by a Port Health team, comprising principal port medical inspector, port health doctor, administrative support, and team leader. In addition, all airports in the UK will have written guidance available for unwell travellers.[78]

United States

Local health officials in Brazos County Texas are investigating a suspected case of 2019-nCoV. The patient is a Texas A&M student who had recently travelled from Wuhan, China, where the coronavirus originated. The patient is currently in isolation at his home, while the precautionary testing is being done. Results of the testing are expected to be completed by 24 January.[126]

On 22 January an American Airlines passenger arriving at Los Angeles International Airport from Mexico City received medical attention upon arrival, American spokesman Curtis Blessing said. He was transported to a medical center for disease control for precautionary reasons. [127]

Malaysia

The director general of the Ministry of Health, Noor Hisham Abdullah, said thermal scanners were being used to screen travellers at border points, and that the Malaysian health authorities were placed on high alert following the global outbreaks.[133]

Netherlands

Airlines and the main international airport Schiphol are, as of 22 January, not taking extra measures yet against the spread of the virus, stating the lack of direct flights from or to Wuhan.[134]

North Korea

As a precaution against the virus, North Korea is to temporarily ban foreign tourists until the government feels that the virus is well under control.[135]

Panama

The Panamanian government has enhanced its sanitary control measures at all ports of entry, in preparation for the arrival of the virus.[136]

Sri Lanka

The Ministry of Health in Sri Lanka informed the Quarantine Unit at Bandaranaike International Airport to screen passengers for symptoms. Additionally, the ministry warned that infants, children, pregnant mothers, elderly and people who suffer from chronic diseases among other issues should avoid visiting crowded places when possible.[137]

Turkey

The Ministry of Health announced that Turkey has arranged quarantine rooms, inspection centres and thermal cameras for screening at the airports as added precautions, even though the World Health Organization does not consider them necessary for the country.[138]

United Arab Emirates

On 23 January 2020, Dubai Airport announced that travelers arriving directly from China would have their temperatures screened.[139]

Symptoms at Clinical presentation

Reported symptoms have included fever in 90% of cases,[13] fatigue and a dry cough in 80%,[13][140] and shortness of breath in 20%, with respiratory distress in 15%.[38][77][140] Chest x-rays have revealed signs in both lungs.[38][77]Vital signs were generally stable at the time of admission of those hospitalised.[140] Blood tests have commonly shown low white blood cell counts (leucopenia and lymphopenia).[13]

Testing

On 15 January 2020, the WHO published a protocol on diagnostic testing for 2019-nCoV, developed by a virology team from Charité Hospital in Germany.[141]

Prevention and manageme

Airport screening

2019-nCoV does not currently have an effective medicine treatment or vaccine, though efforts to develop some are underway.[142][143] Its symptoms include, among others, fever, breathing difficulties and coughing,[144] which have been described as “flu-like“.[145] To prevent infection, the WHO recommends “regular hand washing, covering mouth and nose when coughing and sneezing… [and] avoid[ing] close contact with anyone showing symptoms of respiratory illness (such as coughing and sneezing).”[51] Though there are no specific treatments for general human coronaviruses, the U.S. CDC provides generic advice that an infected person can relieve their symptoms by taking regular flu medications, drinking fluids and resting.[146] Some countries require people to report flu-like symptoms to their doctor, especially if they have visited mainland China.[147]

The situation in Wuhan is being monitored with respect to the forthcoming third round of the 2020 AFC Women’s Olympic Qualifying Tournament, some of which is due to be played there over the course of the tournament’s span from 3 February 2020 to 9 February 2020.[148] On 22 January 2020, the AFC announced that it would be moving the Group A matches previously scheduled to be played in Wuhan—which included the respective squads from Australia, China PR, Taiwan and Thailand—to Nanjing instead due to the coronavirus outbreak.[149]

An effective quarantine on travel in and out of Wuhan was imposed from 23 January 2020, 10:00 onwards. Flights and trains in and out of Wuhan, public buses, the metro system and long-distances coaches were suspended until further notice. The move is an effort to stop the spread of the virus out of Wuhan, and to ensure the health and safety of the people, according to China’s Xinhua News Agency. Large-scale gatherings and group tours were also required to be suspended.[150] Various logistic issues have occurred after the quarantine, including rising food prices[151] and difficulty for medical staff commuting to the hospital.[152]